Health Insurance

Changing from a Marketplace Plan to Medicare

July 27, 2017

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Changing from a Marketplace Plan to Medicare

The most common age for someone’s Medicare coverage to begin is 65. The enrollment for Medicare takes place three months prior to your 65th birthday and the period extends until three months after that birthday. A common question that marketplace plan holders at that age encounter is how to change from their marketplace plan to Medicare. While Medicare is not part of the marketplace, the type of Medicare plan you have is still scrutinized by the new as to whether you have sufficient coverage. If your Medicare does not cover your health care fully, you may be considered uninsured under the law and therefore penalized.
If you have just Medicare Part A (hospital insurance), you are considered covered under the law, but if you only have Part B (medical insurance) you are not considered to have coverage and may have to pay a fee as a result. Under the ACA, Medicare benefits have expanded—preventative care, wellness, and cancer screenings are all covered under the law and there is often opportunity to save money on prescription drugs depending on your plan.Making the Switch
As mentioned, the enrollment period for Medicare lasts six months, with the applicant’s 65th birthday as the central point. It is to your advantage to switch to Medicare because you can get a tax credit that isn’t available if you keep strictly to a marketplace plan. When you become eligible for Medicare, you will have to cancel your marketplace plan. You can do so online. You will be asked a series of questions to determine how to cancel the plan.

If you’re the only person in your household enrolled in your marketplace plan, you will simply cancel the whole plan. If only your spouse needs to end the plan, you will keep coverage for yourself and end it for your spouse, who will be going on Medicare. Depending on whether your spouse is the household contact (the person who created the healthcare marketplace account), you may need to change your plan to make yourself the household contact. More information on exactly how to cancel can be found here: https://www.healthcare.gov/how-to-cancel-a-marketplace-plan/.

Make sure that you are prompt in cancelling your marketplace plan and enrolling into Medicare, as delaying can lead to a gap in coverage that could be catastrophic if you happen to have a health crisis while in that gap period. In most cases, coverage ends immediately upon cancelling the marketplace plan. However, this is dependent upon the date of cancellation:

If someone cancels on or before the 15th of the month, coverage ends on the last day of the current month.
If someone cancels after the 15th of the month, coverage ends on the last day of the following month.

Canceling your marketplace plan in favor of Medicare is not difficult and for the most part, Medicare has remained unaffected by the ACA. It is important to remain prompt in your cancellation and enrollment to avoid any gaps in coverage.